Advanced Search

Neurology & Pain Management Coding Alert

Reader Question:

64614 Applies to Multiple Gastrocnemius Injections

Published on Sun Nov 25, 2012

Question: The physician documented, "50 units of Botox was injected in two sites of the medial and lateral gastrocs of the right leg." Medicare only allows payment for one injection per site, regardless of the number of injections made to the site.  Is the right leg; medial and lateral gastroc considered a single muscle? Florida Subscriber   Answer: In this scenario, the physician is referring to the gastrocnemius, a very powerful muscle found on the back part of the lower leg. Its primary function is plantar flexion and is used in standing, walking, running and jumping. The gastrocnemius muscle is made up of two parts or "heads" -- the medial (inside) and the lateral (outside). So, yes, the medial and lateral gastrocnemius is a single muscle, but chemodenervation coding is not based on individual muscles. The code for the chemodenervation injections would be 64614 (Chemodenervation of muscle[s]; extremity[s] and/or trunk muscle[s] [e.g., for dystonia, cerebral palsy, multiple sclerosis]) x 1 unit of service.

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All